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New Rx for Health Plan: Split Bill

By

Jonathan Weisman and

Naftali Bendavid

Updated Aug. 20, 2009 11:59 p.m. ET

The White House and Senate Democratic leaders, seeing little chance of bipartisan support for their health-care overhaul, are considering a strategy shift that would break the legislation into two parts and pass the most expensive provisions solely with Democratic votes.

The idea is the latest effort by Democrats to escape the morass caused by delays in Congress, as well as voter discontent crystallized in angry town-hall meetings. Polls suggest the overhaul plans are losing public support, giving Republicans less incentive to go along.

Greeley, Colo., citizens line up to attend a health-care town-hall meeting with Rep. Betsy Markey, (D., Colo.), on Wednesday. Rep. Markey had planned to speak to small groups, but so many people turned out that she ultimately had to hold a meeting in a college auditorium. Audience members, both for and against health-care reform, calmly questioned her on the issues.
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Democrats hope a split-the-bill plan would speed up a vote and help President Barack Obama meet his goal of getting a final measure by year's end.

Senators on the Finance Committee are pushing ahead with talks on a bipartisan bill. Democratic leaders say they hope those talks succeed but increasingly are preparing for the possibility that they do not.

Most legislation in the Senate requires 60 votes to overcome a filibuster, but certain budget-related measures can pass with 51 votes through a parliamentary maneuver called reconciliation.

In recent days, Democratic leaders have concluded they can pack more of their health overhaul plans under this procedure, congressional aides said. They might even be able to include a public insurance plan to compete with private insurers, a key demand of the party's liberal wing, but that remains uncertain.

Other parts of the Democratic plan would be put to a separate vote in the Senate, including most of the insurance regulations that have been central to Mr. Obama's health-care message.

That bill would likely set new rules for insurers, such as requiring they accept anyone, regardless of pre-existing medical conditions. This portion of the health-care overhaul has already drawn some Republican support and wouldn't involve new spending, leading Democratic leaders to believe they could clear the 60-vote hurdle.

Senate Democrats are considering a radical approach to passing the health-care bill by splitting it into two parts. White House correspondent Jonathan Weisman explains how the strategy would work.

Senate Majority Leader Harry Reid is the key decision-maker on whether to use the tactic, but several congressional aides said White House officials are being kept abreast of the talks.

"We will not make a decision to pursue reconciliation until we have exhausted efforts to produce a bipartisan bill," said Jim Manley, a spokesman for Mr. Reid. "However, patience is not unlimited, and we are determined to get something done this year by any legislative means necessary."

Privately, those involved in the talks now say there is a 60% chance the split-bill tactic will be used. Mr. Obama is huddling with aides next week, and Senate leaders are likely to review their options when Congress reconvenes after Labor Day.

The likelihood of a strategy shift has grown after the negative response of Republicans to overtures of compromise.

On Sunday, Health and Human Services Secretary Kathleen Sebelius said a public plan, strongly opposed by Republicans, wasn't the "essential element" of a comprehensive bill.

White House spokesman Robert Gibbs continued to insist Wednesday that Ms. Sebelius didn't mean to signal the White House was abandoning the public plan. A senior Democratic congressional leadership aide said weekend statements were calculated to test Republican responses.

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Sen. Jon Kyl of Arizona said Tuesday nonprofit insurance cooperatives, which centrist Democrats have suggested as an alternative to a public plan, were nothing but a "Trojan horse" that would lead to excessive government control of health care.

"It's fair to say the steam is going out of these bipartisan negotiations," the Democratic aide said.

House committees have passed bills that include a public option and new programs that would make insurance available to most Americans who lack it. If the Senate passes its own bill, the two chambers must hash out a compromise that could go to the president for signing. The public option could be the biggest point of contention between House and Senate.

Senate Finance Committee members working on a bipartisan bill are scheduled to talk Thursday on a conference call. "The Finance Committee is on track to reach a bipartisan agreement on comprehensive health-care reform that can pass the Senate," Sen. Max Baucus (D., Mont.), chairman of the Finance Committee, said in a statement.

But other senators noted privately that several factors are working against any deal. Many Democrats now believe it's a long shot. Mr. Baucus has set a deadline of Sept. 15 to reach agreement.

Several softer deadlines have already come and gone without a deal. One Republican senator, Orrin Hatch of Utah, has dropped out of the talks. The remaining Republicans have suggested they would only support something that had the backing of many GOP colleagues.

Still, the three Republicans negotiating with Sen. Baucus said Wednesday they believed a deal could be reached. "I'm hopeful," Sen. Olympia Snowe (R., Maine) said. "It's not without challenges, because of the complexity and the costs associated with it. We recognize that. And that's why it has consumed the amount of time that it has."

Sen. Mike Enzi (R., Wyo.) said the Democrats would be making a mistake by forging ahead on their own. "We need to get a bill that 75 or 80 senators can support," he said. "If the Democrats choose to shut out Republicans and moderate Democrats, their plan will fail because the American people will have no confidence in it."

Democrats also must deal with intraparty differences. They can't agree whether a public-insurance option is essential, as liberals say, a "preferred option" -- the White House stance -- or a bad idea, as some on the Finance Committee believe.

If a deal is not reached by mid-September, Mr. Baucus plans to present a bill that is likely to have little if any Republican support. At that point, Democrats will have to decide whether to proceed under the reconciliation process, which allows legislation to pass with a filibuster-proof 51 votes.

The idea of using reconciliation angers even such moderate Republicans as Ms. Snowe. "At a time when we need to bolster the public's confidence in whatever we do with health care, I don't think the reconciliation process will serve the purpose of providing affordable health security for all Americans," she said.

New Rx for Health Plan: Split Bill

The White House and Senate Democratic leaders, seeing little chance of bipartisan support for their health-care overhaul, are considering a strategy shift that would break the legislation into two parts and pass the most expensive provisions solely with Democratic votes.